NPIMap

Organization Active NPI

Bstsa Inc Dba Spectrum Therapy Center

Doing business as Spectrum Therapy Center

  • Speech-Language Pathologist
  • Snellville, GA
National Provider Identifier
1245796424
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
BSTSA INC DBA SPECTRUM THERAPY CENTER
Doing business as
Spectrum Therapy Center
Practice address
2346 Wisteria Dr
Snellville, GA 30078
Phone
(770) 609-6789
Fax
(678) 395-4901
NPI assigned
Feb 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bradford Lee Tucker
Title
President
Phone
(770) 609-6789

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary
Physical Therapy Clinic/Center 261QP2000X
Primary Care Clinic/Center 261QP2300X
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

2346 Wisteria Dr
Snellville, GA 30078

Mailing address

1373 Chloe Dr
Lawrenceville, GA 30043-8383
Phone (843) 655-3731

Other names 1

  • Spectrum Therapy Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1245796424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 CHLOE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438383",
            "telephone_number": "843-655-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 WISTERIA DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-609-6789",
            "fax_number": "678-395-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSTSA INC DBA SPECTRUM THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-13",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-609-6789"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.